Orthodontic Coverage: Does dental insurance cover braces?

Whether you already have dental insurance or are considering enrolling in a dental plan through your employer, you may be wondering about coverage for orthodontics – the dental specialty dedicated to treating crooked teeth, jaw misalignment, crowded teeth and various bite issues. Coverage for orthodontic treatments differs from plan to plan, and some plans don’t cover these treatments at all. That’s why it’s important to find out all the details about your current plan, or any dental insurance plans you may be considering. This article can help by telling you about:

• What orthodontic treatment is, and what conditions it treats

• What are braces, aligners, and retainers

• How much can orthodontic care cost without insurance

• What to look for in a dental insurance plan

What is orthodontics, and what does it treat?

Orthodontics is a dental specialty that treats problems with tooth and jaw alignment, frequently those that are causing an irregular bite. These include:

• Crooked, crowded or overlapping teeth

• Large spaces between teeth

• Overbite and underbite

• Jaw misalignment

• Early or late loss of baby teeth

• Teeth that do not meet when the mouth is closed

While some people associate orthodontics with children and adolescents, it’s important to note that orthodontists treat patients of all ages. Many adults need orthodontic care for either medically necessary or cosmetic purposes, and fortunately, it's never too late to correct most tooth and jaw problems.

What do orthodontists use to treat their patients?

While metal braces may be the first thing that comes to mind, orthodontists may use a variety of dental devices to straighten and realign teeth and correct irregular bites. While serious problems with jaw alignment may require more intensive treatment with multiple devices, the majority of orthodontic issues are resolved using:

• Metal braces: Also known as traditional braces, these are still the most widely used orthodontic devices. They are bonded to the teeth and generally require the use of elastic bands.

• Ceramic braces: These work the same way as traditional braces but use clear ceramic brackets. Some patients prefer them because they are less noticeable.

• Aligners: Aligners are clear, plastic trays that fit closely to the teeth. Aligners are removable and less visible than braces, and many patients find them more comfortable than braces. However, they are usually not recommended for patients with serious orthodontic issues.

• Retainers: Removable retainers are generally used after treatment with braces or aligners. Retainers help to ensure that teeth don’t revert to their pre-treatment alignment.

How much does orthodontic treatment cost without insurance?

Without insurance, orthodontics can be very expensive. While costs will vary depending on the nature of the problem, your location, and your choice of orthodontists, here are some average figures:¹

• Traditional metal braces: $3,000 to $7,500

• Clear ceramic braces: $2,000 to $8,500

• Aligners: $3,000 to $7,000

While the expense can be high, it doesn’t have to keep you from seeking needed treatment. Choosing dental insurance that covers braces and other standard treatment options can help keep costs at a reasonable level.

What should you look for in a dental plan?

If you or someone in your family needs orthodontic services, here are some questions to ask when reviewing your current dental insurance coverage or looking for a new plan:

• Does the plan offer full coverage dental insurance?

• Is it a PPO plan with a wide network of orthodontists?

• What specific orthodontic services are covered?

• Does the plan cover the cost of braces or aligners? If so, what percentage?

• Is there a waiting period before orthodontics are covered?

• Are there coverage limits such as an annual or lifetime maximum benefit?

• Is there an age limit for orthodontic coverage?

• Does the plan cover cosmetic orthodontics or only medically necessary services?

How to find out more about your dental coverage

If your current plan is through your employer, you can probably get quick answers from your benefits administrator.